Recovering from Tinnitus:

My Recovery from Tinnitus and the Research that I Uncovered, that
Matters to You.

by Kevin Hogan, 1996

The noise turned on at 80 dB and I needed relief now. I knew what
tinnitus was, because just a few weeks before, I had experienced some
head noise that was loud for several hours but faded. I knew the noise
was called tinnitus because I had looked it up in Britannica. I didn't
know anything else about it. This time, at 2 AM, August 1, 1993; the
80+ dB noise was relentless. It woke me up out of sleep. I turned on
the TV and then turned the volume all the way up. I put a fan on by my
head on high. I couldn't stand the head noise and the external noise
didn't cover the internal noise in any significant way. It didn't go
away and I was despondent. I called my physician when his office
opened. He recommended calling the American Tinnitus Association for
information and then scheduled an appointment to see me. The ATA told
me there was a medication called Xanax that could reduce the noise and
did in most people that used it. This was the beginning of my new life.
Life with tinnitus, which eventually went away, but only after reading
over 1,000 abstracts, papers and articles, and several serious
reflective days where suicide was strategically planned. Life, late
that summer, was something I felt I could no longer contribute to...

Xanax

...I once used street drugs in college and had learned how incredibly
stupid that was. When the doctor told me Xanax may be habituating, I
was torn between dealing with the drug or the noise. The noise was 80dB
and the research was clear:

76% of individuals using Xanax gained relief by more than 40%
volume reduction in their tinnitus. It would take 8-12 weeks for the
drug to make an impact.(1)

...76% is most people...but I was not comfortable with the odds. Never
having been a lucky person, I figured myself as part of the 24% with no
change. I started the prescription and felt groggy. The next step was
to take some time off of work and go to the library. The inter-library
loan librarian was inundated with my request for hundreds of articles,
journals, books, periodicals, that I was finding may contain
information. We found phone numbers of the few specialists in the
United States and I called them. A few treatments were having success.
Most were not. Those treatments that were having success looked
unpleasant.

Seldane

The end of August is upon our small family of three and our new
motorhome is sitting waiting for me to get healthy so we can take a
vacation. Driving it though is exacerbating the sounds in my head. My
new theory of my cause for the tinnitus is that I'm having allergies. I
quit eating various foods, stay away from electromagnetic frequencies,
and decide that leaving for vacation just might do the trick. I read a
study that shows that says:

60% of individuals who use Seldane experience some reduction in
the volume of their tinnitus.(2)

The study wasn't all that well done, as far as I understood it,
at that time, but I decided to talk to the doctor. He agreed it was
worth attempting. 30 day trial prescription. Still taking the Xanax
with no effect....

We take 10 days off and drive to Cape Cod from our Minnesota
home. We love Cape Cod and some of our best experiences in life have
been there. Knowing from my hypnosis education how important the
environment is to you on a psychological basis, off we go....to Cape
Cod and still ringing in the high 70's. It was on this trip, as I sat
by one of my favorite spots, alone, attempting to meditate and pray,
that I first seriously decided that life wasn't worth participating in
for me. I was seemingly useless to my wife and daughter. I felt as if
the world now revolved around my noise. Everything was out of
perspective. Over 30 days into the Xanax and 10 into the Seldane. All I
felt was tired and depressed.

My wife talked me out of suicide, thank God. The depression and
chronic fatigue continued. We were now home and money was running thin.
Time to go back to work. Ironically, I continued to help individuals
with chronic illness improve their conditions, but I was getting
nowhere.

Pamelor; Stress, Anxiety, Depression and Panic
Attacks

We discontinued the Seldane and continued the Xanax knowing it
could still take weeks for it to "kick
in." I had gotten the name of a
Dr. Mark Sullivan out east. He had done some research on Pamelor as a
treatment for tinnitus. I remember thinking that ..Pamelor helped about
40% of individuals to reduce their tinnitus.(3)

A simple math equation reminded me that between the three
medications listed above, my chances were over 95% that at least one
would be helpful!

<1-{(.24)(.4)(.6)}>

Pamelor also seemed to be a logical choice as I had been
experiencing a great deal of stress, anxiety and depression for
sometime, before the onset of tinnitus. The tinnitus simply made
everything worse. The research I had been reading at that time clearly
indicated that I was not alone. In fact, most people with tinnitus,
experienced,

The encouraging news for me was that tinnitus wasn't simply an
"ear phenomenon."
There was a reasonable correlation between emotional
distress, which is very treatable and tinnitus which according to most
professionals, was not. In fact, the relationship between what is
called subjective tinnitus and (S.P.A.D.E.) was the norm for most
clients I would later work with. Another interesting paper I came
across noted that once an individual had tinnitus, he became far more
likely to acquire other somatics (pains and illnesses) than someone
without tinnitus.(9)

This was the first link that I made that hypnosis actually may be
a useful treatment for tinnitus. Many of my clients whose illnesses and
pains seem to expand into more somatics, were generally excellent
candidates for elimination of chronic illness via hypnotherapy. I began
to investigate....but my tinnitus was still in the 70+ dB range and the
hyperacusis I experienced was becoming more frustrating to deal with
every day.

Then sometime in October, the Pamelor was prescribed by my
doctor. The tinnitus immediately skyrocketed back into the 80's and it
moved around my head. It was very scary. I called the doctor and asked
to be taken off and he explained to me the neurological impact of
Pamelor in the brain and its likelihood to decrease the volume. I
agreed to continue but I was scared. Then a few weeks into the new
prescription, the Pamelor completely eliminated my tinnitus. It kicked
in with the Xanax and the tinnitus was almost completely gone. The
Pamelor days would be short though as the side effects mounted. Dry
mouth, fatigue, very high blood pressure. The doctor said we couldn't
continue with the Pamelor. I protested of course. I didn't care about
the side effects, compared to the benefits I was receiving from the
medication. Silence was wonderful, even at the price I was paying fo
r it. No matter, Thanksgiving came and the Pamelor went. Zoloft, a
substitute was prescribed in its stead. The tinnitus returned, into the
60's range most days. The side effects were gone, but the noise had
returned.

Hypnotherapy works?

Christmas came and went. We sold the motorhome. I couldn't drive
it, so it didn't really matter. I was busy with clients and my research
but I was only finding case studies until early in 1994 I began
uncovering reams of hypnotherapeutic research. The research explained
that tinnitus needed to be treated like phantom pain (10) (11). I had
done that many times. That would be easy. Tinnitus would yield to
traditional modes of regression.(12) Tinnitus could be blocked at the
cortical level by hypnosis in half the cases. (13) Tinnitus could be
alleviated by self hypnosis tapes designed for tinnitus reduction if
they were carefully designed by the practitioner, in over 69% of cases.
(14) Essentially, I determined that over 80% of people should gain
benefit through hypnotherapy, reducing the volume and/or the emotional
impact that went along with it. I liked my chances and began practicing
self hypnosis at night in lieu of the temazapam I had been taking for
sleep. It took about six weeks to really become effective at
habituating to the tinnitus for sleeping, which was my worst part of
the "day."

Occasionally on a bad day during this habituation process, I took
a temazepam for sleep, but that was the exception and not the rule. The
hypnotherapeutic tapes and self hypnosis that I practice succeeded
beyond my wildest dreams. I habituated the tinnitus. It was one year
later. The sound was in the 40's and 50's on many days, but it rarely
mattered. By 1994 years end, the tinnitus began to permanently
habituate. During all of 1995 and 1996, the tinnitus would return home
and remind me that it still new where I was but the noise never
bothered me again. Occasionally noise would come above threshold, maybe
20dB. I decided to come off the Xanax first and then the Zoloft.
Except for a few very annoying days of letting the body re-adjust
itself to being medication-free, the process was a complete success.
The tinnitus did not increase after eliminating the medications. I
was, in effect, cured.

During 1995, my work with clients from all over the country was
in full stride. The phone calls, faxes and e-mails never stopped, and
don't to this day....and now the research that has been released in
these last two years has validated my earlier speculations about
tinnitus. In fact the important papers released in 1995 and 1996 are
among the most important ever. They essentially prove that hypnosis and
other cognitive therapies like biofeedback are the most likely road to
success for most individuals with tinnitus. (The caveat being that
hypnotherapy and biofeedback are practitioner dependent for success,
and that drugs are not. You MUST have a qualified hypnotherapist and
not someone who has little or no understanding of tinnitus.)

When I wasn't working with clients, I accelerated my extension work in psychology. I was figuring out that the easiest way to get tinnitus to return was to not have a very occupied mind. It worked.

Staying Current for my Clients

Here are just a couple of the most recent exciting research
findings that have appeared on the "tinnitus scene."

What I learned in 1995 was that tinnitus in many clients is a
recursive loop of memory, or put another way, is enmeshed into their
memory and conscious awareness. This may indicate that hypnosis may
indeed be able to block the tinnitus below the cortical level and from
awareness, and at worst we could teach the client to create new
perceptions that would allow the conscious mind to be filled with other
stimuli and not the tinnitus. The theory and experience was validated
when I read an unrelated study by Dr. Abraham Shulman which discusses
where tinnitus is located in the brain. I merged his work with SPECT
analysis(15), and my experience with hypnotherapy into a successful
therapeutic regimen, and, it has indeed proven excellent results.

I also discovered that a biofeedback study (which is simple
relaxation and manipulation of visualized images to reduce stress)
again proved that most people can control their emotional response to
tinnitus with proper practitioner guidance. Biofeedback became
popularized over 25 years ago when it was deemed useful to measure the
client response to altered states of consciousness. It was discovered
that most people can reduce their stress level through electronic
monitoring. Biofeedback is generally considered to be a useful
sub-field of hypnotherapy and it is always encouraging to see positive
results for tinnitus sufferers that are taught biofeedback monitored relaxation techniques.(16)

This is just the tip of the recent tinnitus research iceberg. In
the next issue of Hearing Health, we will specifically discuss what the
profoundly deaf can do for their tinnitus reduction, and, we will
insert self hypnosis instructions specifically designed for the hard of
hearing with tinnitus.

Notes:
1. The Xanax study was reported in Arch Otolaryngology Head and Neck
Surgery. 1993:119:842-845 by R. Johnson, B. Brummett, A. Schleuning.
The double blind placebo study showed 76% of individuals using Xanax
had a volume reduction of 40% or more. The control group showed only 4%
improving. Side effects were minimal and the study lasted only 12
weeks. Improvement for most began after 8 weeks on Xanax at 1.5 mg. per
day total.

2. Seldane-study unavailable to author at press.

3. Pamelor-In a personal conversation with Dr. Mark Sullivan, my
understanding was that he was currently working with nortriptyline with
tinnitus sufferers and was experiencing a fair degree of success.
Further, in the biofeedback study, cited in number 16 below, it was
found that 27% of patients improved using Elavil, a close "cousin" to
Pamelor.

4. Stress- A. Shulman in the SPECT study, noted in 15 below, notes
that, "the stress factor has been linked to cortisol accumulation
resulting from a defect in its control of the hippocampus. Its
accumulation has been linked to changes in mood which, over time,
progress from anxiety to depression. The tinnitus patient may develop a
memory not only for normal auditory stimuli but also, paradoxically,
for the aberrant sound, that is tinnitus." Hundreds of studies cite
excessive stress as related to tinnitus annoyance and suffering.
Numerous studies cite excessive stress as highly correlated with
tinnitus onset.

6. Anxiety-J.Cicocon, F. Amede, et.al., in Geriatrics, Feb. 1995, pp.
18-25, note that, "Subjective
tinnitus is more common and may be due to
peripheral or central auditory pathology, a metabolic abnormality, or
anxiety/depression."

7. Depression was reported as prevalent across the lives of 62% of
tinnitus sufferers vs. 21% of a control group by Griffiths, Katon,
Dobie, Sakai, Russo, in the Journal of Psychosomatic Research. Vol. 31,
No. 5. pp. 613-621, 1987. (Current depression was reported in 48% of
tinnitus sufferers vs.. 7% of the control group.)

8. Emotional Problems-In the same study noted in (7), the researchers
noted that the number of psychosocial problems and thus the resulting
disability experienced was significantly greater in the tinnitus group
compared to the controls. The authors was conclusion that treatment
needed to attend to both the tinnitus and the depression when present.
Common challenges facing tinnitus sufferers in at least half of all
cases include clinical depression (75%), insomnia (56%), adverse
effects in lifestyle (93%) and sexual difficulties (52%).

9. Somatics- J. Russo, W. Katon, et. al, noted in Psychosomatics, Vol. 6,
1994, pp. 546-56, "the results revealed that the number of lifetime
medically unexplainable symptoms were significantly, independently, and
positively related to increasing numbers of current and past anxiety and
depressive disorders...and the "worry-pessimism" and
"impulsiveness," subscales...were positively related to the
number of medically unexplained symptoms. The results suggest that
somatization is associated with current and past history of psychiatric
illnesses and harm avoidance in this sample of medical patients."

11. Pawel Jastreboff, in the British Journal of Audiology, 1993, pps.
7-17, noted that, "in the vast majority of cases tinnitus is a phantom
auditory perception, perceived exclusively by the patient...(and among
the problems tinnitus brings-)...extremely strong imprinting of the
tinnitus sound on the patient's central nervous system."

12. Dianetics, Hubbard, L., 1950, Bridge Publishing.

13. Crasilneck and Hall, in their text of Clinical Hypnosis announced
that 50% reduction in symptoms can be achieved, "probably through
blocking awareness at a cortical level."
Supporting this theory, is the
text, Hypnosis: Current Clinical, Experimental and Forensic Practices,
edited by Michael Heap: "Hypnosis appears to be a natural choice
of....treatment for tinnitus, not only as a relaxation method but also
as a means of modifying or even blocking sensory awareness...There are
a number of comments and reports in the literature concerning tinnitus
sufferers."

14. G. Brattberg, at the Sandvikens Hospital in Sweden did a
longitudinal study of patients using a self hypnosis tape after just
one session of hypnotherapy with a client. 69% cited improvement,
regardless of cause. Three patients of the 32 studied announced a cure.
Most were sleeping better, having significant improvement in critical
lifestyle areas. Numerous other studies support Brattberg's findings.

15. A. Shulman, A. Strashun, et al. discussed at the Triological
Society, 1993, NY, that, "SPECT results of brain demonstrate for the
first time the in vivo significance of the organacity of brain for a
central type tinnitus...auditory function can be considered to involve
multiple neural networks reflecting various attributes of hearing...It
can be speculated that a short term memory is established for tinnitus
in the medial temporal lobe memory system which becomes stored in
associated areas of the neo-cortex. A paradoxical memory for tinnitus
may cause the tinnitus to become clinically manifest as a severely
disabling tinnitus."

16. L. Podoshin, Y. Ben-David, et. al., researched the differences of
tinnitus in both resting and active situations for their patients.
43.5% of biofeedback patients experienced improvement at rest and 24%
during activity, outperforming those using the drug Elavil.

WHO SHOULD OWN THIS PROGRAM?
Anyone with tinnitus who would like to reduce the volume of their tinnitus through the use of self-hypnosis CDs, along with other strategies presented in the program.

The Tinnitus Reduction CD Program has helped thousands of individuals reduce the distress associated with tinnitus. In most cases, when individuals utilize the Tinnitus Reduction Program as part of a multi-modality approach to tinnitus reduction they experience long term improvement.

"I had meant to write before as I have had your tapes from July now. They have been wonderful and saved my sanity. My tinnitus is greatly reduced and my Meniere's under control. I return to your tapes as I find them excellent and I use them every night to go to sleep with. Thank you." Anne Clarke

Your CD program includes three hours of up to date information about how to reduce the volume and distress of your tinnitus. This portion of the program is updated regularly.

In addition to the reporting you will receive of what is working in the area of medicine, tinnitus retraining therapy, and other modalities, you will receive self hypnosis CD's specifically designed by Kevin Hogan which assisted him in the elimination of his tinnitus. The first two CD's in the program are the most up to date information about tinnitus relief you can get. Now, you can utilize the same program as part of a multi-modal effort in reducing your tinnitus volume.

Kevin Hogan is a psychotherapist specializing in hypnosis, who didn't stop with just one possible way to experience silence. A multimodal approach is the only way to assure your success in reducing your tinnitus volume and the intense emotional distress that comes from the tinnitus. If you are sick of hearing that "nothing can be done" and "you'll have to learn to live with it," this is the starting point.

The program includes the brand new revised edition of, Tinnitus: Turning the Volume Down which includes the latest developments in reducing tinnitus and hundreds of citations for further research.

Tinnitus Reduction CD Program and the 260 page book, Tinnitus: Turning Down the Volume

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